At What Price? The Potential Health Risks of Skin-Lightening for Brighter Skin

Skin lightening practices are prevalent in the U.S., particularly among individuals of color, especially women. However, a recent Northwestern Medicine study suggests that many users of these products might not fully grasp the associated risks. The study emphasizes that these practices are often driven by colorism, a societal bias that favors lighter skin tones as more desirable and advantageous. The findings underscore the widespread nature of skin lightening in the U.S.

The study’s lead investigator, Dr. Roopal Kundu, founder and director of the Northwestern Medicine Center for Ethnic Skin and Hair, expressed surprise at the lack of awareness regarding the ingredients in over-the-counter products and their potential detrimental effects. These products are commonly purchased from various outlets, including chain grocery stores, community-based stores, and online, without undergoing the same rigorous regulation as large-chain or prescription products.

Kundu, a professor of dermatology at Northwestern University Feinberg School of Medicine and a board-certified dermatologist at Northwestern Medicine, pointed out that previous studies have revealed that these products are often adulterated with substances such as steroids and mercury, which can be harmful to the skin. One of Kundu’s patients suffered permanent hyperpigmentation from using a lightening product called hydroquinone.

While skin lighteners are prescribed by doctors for certain skin conditions like melasma, they can be safely used under proper medical guidance. However, many users do not consult a medical provider before using these products. In 2020, the FDA received reports of serious side effects from skin-lightening products containing hydroquinone, leading to a warning to consumers about their potential harm.

The study found that individuals using skin lighteners, primarily women, perceived stronger colorism in their lives compared to those who did not use such products. The perception is that lighter skin within specific ethnic groups is viewed more favorably and is associated with increased attractiveness and professional success.

While most patients seeking skin lightening with Dr. Kundu do so to address uneven skin tone due to a skin disease, a significant portion of the study participants expressed a desire for general skin lightening. The study involved sending an anonymous 19-question survey to individuals with skin of color in the U.S. A total of 455 individuals completed the survey, representing various ethnic backgrounds, and 21.3% reported using skin-lightening agents.

Understanding the cultural and societal influences on skin health and disease treatment is crucial for dermatologists. Cultural mindfulness allows clinicians to provide safe, effective, comprehensive, and compassionate treatment for dermatological conditions across all communities.

Reference: “Colorism attitudes and use of skin lightening agents in the United States” by Karishma Daftary, Sneha Poondru, Nina Patel, Maxwell Shramuk, Lutfiyya Muhammad and Roopal V. Kundu, October 2023, International Journal of Women’s Dermatology. DOI: 10.1097/JW9.0000000000000092.

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